Surgical stapling device

ABSTRACT

A surgical device is disclosed which includes a handle portion, a central body portion and a SULU. The SULU includes a proximal body portion, an intermediate pivot member and a tool assembly. The intermediate pivot member is pivotally secured to the proximal body portion about a first pivot axis and the tool assembly is pivotally secured to the intermediate pivot member about a second pivot axis which is orthogonal to the first pivot axis. The SULU includes a plurality of articulation links which are operably connected to the tool assembly by non-rigid links. The articulation links are adapted to releasably engage articulation links positioned in the central body portion. The body portion articulation links are connected to an articulation actuator which is supported for omni-directional movement to effect articulation of the tool assembly about the first and second axes. The handle portion includes a spindle and barrel assembly drive mechanism for advancing and retracting a drive member positioned in the tool assembly. In one embodiment, the tool assembly includes a cartridge assembly having a plurality of staples and an anvil assembly.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patentapplication Ser. No. 11/652,756, filed Jan. 12, 2007, which is acontinuation of U.S. patent application Ser. No. 11/543,640, filed onOct. 3, 2006, which is a divisional of U.S. patent application Ser. No.10/871,342, filed on Jun. 17, 2004, now U.S. Pat. No. 7,159,750, whichclaims priority to U.S. Provisional Patent Application Ser. No.60/479,379, filed Jun. 17, 2003, now expired, the entire disclosures ofeach are incorporated herein by reference.

BACKGROUND

1. Technical Field

The present disclosure relates to a surgical stapling device and, moreparticularly, to an endoscopic surgical stapling device having a toolassembly which is articulatable about first and second perpendicularaxes.

2. Background of Related Art

Surgical devices wherein tissue is first grasped or clamped betweenopposing jaw structure and then joined by surgical fasteners are wellknown in the art. In some instruments a knife is provided to cut thetissue which has been joined be the fasteners. The fasteners aretypically in the form of surgical staples but two part, includingpolymeric, fasteners can also be utilized.

Instruments for this purpose can include two elongated members which arerespectively used to capture or clamp tissue. Typically, one of themembers carries a staple cartridge which houses a plurality of staplesarranged, for example, in at least two lateral rows while the othermember has an anvil that defines a surface for forming the staple legsas the staples are driven from the staple cartridge. Generally, thestapling operation is effected by cam bars that travel longitudinallythrough the staple cartridge, with the cam bars acting upon staplepushers to sequentially eject the staples from the staple cartridge. Aknife can travel between the staple rows to longitudinally cut thestapled tissue between the rows of staples. Such staplers are disclosedin U.S. Pat. Nos. 6,250,532 and 6,241,139 which are incorporated hereinbe reference in their entirety.

In endoscopic or laparoscopic procedures, surgery is performed throughsmall incisions or through small diameter cannulas inserted throughsmall entrance wounds in the skin. Due to the limited degree of motionof an instrument when it is positioned through the skin, it may be quitedifficult for a surgeon to manipulate the tool assembly of theinstrument to access and/or clamp tissue. To overcome this problem,instruments having rotatable endoscopic body portions and rotatableand/or articulatable tool assemblies have been developed and arecommercially available. Although these instruments provide significantimprovements in the endoscopic tool art, further improvements that maydecrease the time required for surgical procedures by allowing surgeonsto more quickly access tissue are desired.

Accordingly, a continuing need exists for an endoscopic or laparoscopicsurgical device having a tool assembly which can be quickly and easilymanipulated to an infinite number of orientations to access, clampand/or cut tissue.

SUMMARY

In accordance with the present disclosure, a surgical stapling device isprovided which includes a handle portion, an elongated central bodyportion and a Single Use Loading Unit (“SULU”) or Disposable LoadingUnit (“DLU”). The elongated body portion is rotatably secured to thehandle portion. The SULU includes a proximal body portion, anintermediate pivot member and a tool assembly. The intermediate pivotmember is pivotally connected to the proximal body portion about a firstaxis and pivotally connected to the tool assembly about a second axissubstantially orthogonal to the first axis. As such, the intermediatepivot member is able to articulate in relation to the proximal bodyportion and tool assembly is able to pivot with respect to theintermediate pivot member. Thus, the tool assembly is able to be pivotedabout multiple axes in relation to the elongated central body portion ofthe device. Since the elongated central body portion of the device isalso rotatable in relation to the handle portion of the device, thecapability of articulation of the tool assembly about multiple axesallows a surgeon to quickly and easily position the tool assembly at aninfinite number of orientations to facilitate operation on body tissue.

In another aspect of the disclosure, the surgical stapling deviceincludes an articulation actuator which is supported on a semi-sphericalbase member for omni-directional or universal movement. A plurality ofarticulation links have a first end operably connected to thearticulation actuator and a second end adapted to be releasablyconnected to articulation links of the SULU. The articulation links ofthe SULU are operably connected to the tool assembly by cables ornon-rigid links such that the articulation actuator can be manipulatedto articulate the tool assembly about either or both of the first andsecond axes.

In another aspect of the invention, the handle portion includes a drivemechanism for moving a firing link and a retraction link for effectingoperation of the tool assembly. The drive mechanism includes a spindlesupported within the handle portion and a barrel assembly slidablypositioned about the spindle. The spindle includes a first guide trackfor receiving a firing rack and a second diametrically disposed guidetrack for slidably receiving a retraction rack. The barrel assemblyincludes a firing pawl which is movable into engagement with the firingrack and a retraction pawl which is movable into engagement with theretraction rack. A first shift ring assembly is provided to selectivelyposition the firing and retraction pawls in relation to the firing andretraction racks, respectively. A handle portion trigger is provided tomove the barrel assembly about and along the spindle to selectively movethe firing rack or retraction rack to operate the tool assembly.

In yet another aspect of the disclosure, the tool assembly is a staplingdevice and the barrel assembly includes a grasper pawl which is movableinto engagement with the firing rack to allow the tool assembly to beoperated in a grasper mode. More specifically, the grasper pawl iscontrolled by a second shift ring assembly and is selectively movableinto engagement with the firing rack to allow the firing rack to move adistance which will, upon operation of the movable trigger, effectapproximation of cartridge and anvil assemblies of the tool assembly butwill not affect firing of staples.

In yet another embodiment of the disclosure, the tool assembly includesa cartridge assembly and an anvil assembly. A drive assembly including aknife bar and an actuation sled are translatable through the toolassembly to simultaneously staple and cut tissue positioned between thecartridge and anvil assemblies. A firing cable and a retract cable eachhave a first portion secured to the drive assembly. The firing cable hasa proximal end secured to a firing link of the SULU which is adapted tobe releasably connected to a firing link of the central body portion.The firing link of the central body portion is operably connected to thefiring rack such that proximal movement of the firing rack effectsdistal translation of the drive assembly through the cartridge assembly.The retract cable has a proximal end connected to a retraction link ofthe SULU. The retraction link of the SULU is adapted to be connected tothe retraction link of the central body portion of the device which isoperably connected to the retraction rack such that proximal movement ofthe retraction rack effects proximal movement of the drive assembly.

In another aspect of the disclosure, a novel connection mechanism isprovided for securing the SULU to the elongated central body portion ofthe stapling device. The connection mechanism facilitates releasableattachment of a SULU having a non-rigid cable driven drive assembly to astapling device.

It is an object of this disclosure to provide a surgical device having aremovable SULU which includes an articulation and/or drive mechanismhaving non-rigid links.

It is another object of (his disclosure to provide a surgical staplingdevice having a rotatable central body portion and a tool assemblyincluding a cartridge assembly and an anvil assembly which is pivotalabout first and second axes which are substantially orthogonal to eachother.

It is yet another object of this disclosure to provide a handle portionhaving a spindle and barrel assembly which facilitates selectiveoperation of an operating member or drive member in a firing oroperating mode, a retraction mode and a grasping mode.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the presently disclosed surgical stapling device aredisclosed herein with reference to the drawings wherein:

FIG. 1 is a side perspective view from the distal end of the presentlydisclosed surgical stapling device;

FIG. 2 is a side perspective view from the proximal end of the surgicalstapling device shown in FIG. 1;

FIG. 3 is a side view of the surgical stapling device shown in FIG. 2;

FIG. 4 is a top view of the surgical stapling device shown in FIG. 3;

FIG. 5 is a side perspective view from the distal end of the proximalbody portion and tool assembly of the SULU of the surgical staplingdevice shown in FIG. 4 with the tool assembly in a non-articulatedposition;

FIG. 6 is a side perspective view from the distal end of the SULU shownin FIG. 5 with the tool assembly articulated about a first axis;

FIG. 7 is a side perspective view from the distal end of the SULU shownin FIG. 6 with the tool assembly articulated about a second axistransverse to the first axis;

FIG. 8 is a side perspective view from the distal end of the surgicalstapling device shown in FIG. 4 with the SULU separated from the centralportion of the central body portion of the surgical stapling deviceshown in FIG. 8 with a handle portion half-section, the rotation controlmember and the articulation actuator removed;

FIG. 9 is a side perspective view from the distal end of the surgicalstapling device shown in FIG. 8, with parts separated and with the SULUnot shown;

FIG. 10 is a side perspective view with parts separated of the proximalend of the central body portion, one half-section of the articulationactuator and actuator base member and one half-section of the rotationcontrol member of the surgical stapling device shown in FIG. 8;

FIG. 11 is a side perspective view from the proximal end of the handleportion and the proximal portion of the central body portion of thesurgical stapling device shown in FIG. 8 with a handle portionhalf-section, the articulation actuator and rotation control memberremoved;

FIG. 12 is a side perspective view from the top of the distal portion ofthe handle portion, rotation control member, articulation actuator andproximal portion of the central body portion of the surgical staplingdevice shown in FIG. 8;

FIG. 13 is a side perspective view from the distal end of the handleportion and the proximal portion of the central body portion of thesurgical stapling device shown in FIG. 8 with a handle portionhalf-section and a half-section of the rotation control member andarticulation actuator removed;

FIG. 14 is a side view of the handle portion and the proximal portion ofthe central body portion of the surgical stapling device shown in FIG. 8with a handle portion half-section, the rotation control member and thearticulation actuator removed;

FIG. 15 is a side perspective view from the distal end of the spindleand barrel assembly of the surgical stapling device shown in FIG. 9;

FIG. 16 is a side perspective view from the distal end of the spindleand barrel assembly shown in FIG. 15 with parts separated;

FIG. 17 is a side perspective view with parts separated of the internalcomponents of the central body portion of the surgical stapling shown inFIG. 8;

FIG. 18 is an enlarged view of the indicated area of detail shown inFIG. 17;

FIG. 18 a is a side perspective view of the SULU of the surgicalstapling device shown in FIG. 8 with the proximal body portion of theSULU shown with parts separated;

FIG. 18 b is a cross-sectional view taken along section lines 18 b-18 bof FIG. 18 a;

FIG. 18 c is a cross-sectional view taken along section lines 18 c-18 cof FIG. 18 a;

FIG. 18 d is a cross-sectional view taken along section lines 18 d-18 dof FIG. 18 a;

FIG. 18 e is a cross-sectional view of the proximal body portion of theSULU shown in FIG. 18 during attachment of the SULU to the central bodyportion of a surgical stapling device;

FIG. 19 is a side perspective view with parts separated of the toolassembly of the SULU shown in FIG. 18 a with mess cables not shown;

FIG. 20 is an enlarged side perspective view of the knife bar of theSULU shown in FIG. 19;

FIG. 21 is an enlarged side perspective view from the distal end of theguide cap of the SULU shown in FIG. 19;

FIG. 22 is an enlarged side perspective view from above of the cartridgeassembly of the SULU shown in FIG. 19, assembled;

FIG. 23 is an enlarged side perspective view of a portion of the distalend of the cartridge assembly shown in FIG. 22 with the cartridge andnose cap removed;

FIG. 24 is a top perspective view from one side of the cartridgeassembly shown in FIG. 22 with parts separated and the firing cable andretract cable shown schematically;

FIG. 25 is an enlarged view of the indicated area of detail shown inFIG. 16;

FIG. 26 is an enlarged view of the indicated area of detail shown inFIG. 16;

FIG. 27 is an enlarged view of the indicated area of detail shown inFIG. 16;

FIG. 28 is an enlarged side perspective view from the distal end of thebarrel assembly body portion of the barrel assembly shown in FIG. 15;

FIG. 29 is a top view of the barrel assembly and spindle shown in FIG.15;

FIG. 30 is a side view of the barrel assembly and spindle shown in FIG.29;

FIG. 31 is a cross-sectional view taken along section lines 31-31 ofFIG. 30;

FIG. 32 is a cross-sectional view taken along section lines 32-32 ofFIG. 29;

FIG. 33 is an enlarged view of the indicated area of detail shown inFIG. 32;

FIG. 33 a is an enlarged horizontal cross-sectional view of a portion ofthe handle portion of surgical stapling device shown in FIG. 1 with thefirst and second shift ring assemblies in their distal-most positionsand the firing pawl engaged with the firing rack;

FIG. 33 b is a horizontal cross-sectional view with portions broken awayof one side of the handle portion of the surgical stapling device shownin FIG. 33 a and with the second shift ring assembly being moved towardsits proximal-most position;

FIG. 33 c is a horizontal cross-sectional view of the handle portion ofthe surgical stapling device shown in FIG. 33 a with the second shiftring assembly moved to its proximal-most position;

FIG. 33 d is a cross-sectional view of the barrel assembly and spindleshown in FIG. 30 with the second shift ring assembly in itsproximal-most position and the grasper pawl disengaged with the firingrack;

FIG. 33 e is a side view of a portion of the handle portion of thesurgical stapling device shown in FIG. 14 with the second shift ringassembly moved to its proximal-most position;

FIG. 33 f is a horizontal cross-sectional view of the handle portion ofthe surgical stapling device shown in FIG. 1 with the first and secondshift ring assemblies moved to their proximal-most positions;

FIG. 33 g is a vertical cross-sectional view of the barrel assembly andspindle shown in FIG. 30 with the first and second shift ring assembliesin their proximal-most positions;

FIG. 34 is a side view of the internal body of a handle portionhalf-section of the handle portion shown in FIG. 33 e;

FIG. 34 a is an enlarged partial cutaway cross-sectional view takenalong section lines 34 a-34 a of FIG. 34;

FIG. 35 is an enlarged side perspective view of a portion of the handleportion shown in FIG. 34;

FIG. 36 is an enlarged view of the indicated area of detail shown inFIG. 35;

FIG. 37 is a perspective view from the distal end of the proximalportion of the SULU and the distal portion of the central body portionof the surgical stapling device shown in FIG. 8 prior to attachment ofthe SULU to the central body portion;

FIG. 38 is a perspective view from the proximal end of the proximalportion of the SULU and the distal portion of the central body portionshown in FIG. 37;

FIG. 39 is a perspective view from the distal end of an articulationlink of the central body portion and an articulation link of the SULUprior to attachment;

FIG. 40 is a side view of the articulation links shown in FIG. 39;

FIG. 40 a is a cross-sectional view of a firing/retract link of thecentral body portion and a firing/retract link of the SULUinterconnected by an intermediate link;

FIG. 41 is a perspective view of the distal end of the central bodyportion of the surgical stapling device shown in FIG. 8 with the outertube removed;

FIG. 42 is a perspective view from the distal end of the central bodyportion shown in FIG. 41 with the hub member removed;

FIG. 43 is an enlarged view of the indicated area of detail shown inFIG. 1, prior to attachment of the SULU to the device;

FIG. 44 is an enlarged view of the indicated area of detail shown inFIG. 2;

FIG. 45 is a side perspective view from the distal end of the proximalportion of the SULU and the distal portion of the central body portionof the surgical stapling device shown in FIG. 8 during attachment of theSULU to the central body portion;

FIG. 46 is a side view of a SULU articulation link and a central bodyportion articulation link during attachment of one to the other;

FIG. 47 is a side perspective view of the proximal end of the deviceSULU and the distal end of the device central body portion shown in FIG.45 just prior to full attachment of one to the other;

FIG. 48 is a side perspective view of the proximal end of the deviceSULU and the distal end of the device central body portion with the SULUfully attached to the central body portion;

FIG. 49 is an enlarged view of the indicated area of detail shown inFIG. 1;

FIG. 50 is an enlarged view of the indicated area of detail shown inFIG. 2;

FIG. 51 is a perspective view from the distal end of the proximal end ofthe cartridge carrier portion, the intermediate pivot assembly and themounting member of the surgical stapling device shown in FIG. 8, withparts separated;

FIG. 52 is a bottom perspective view of the proximal end of thecartridge carrier portion shown in FIG. 51 with an articulation cableattached thereto;

FIG. 53 is a top perspective view of the proximal end of the cartridgecarrier portion shown in FIG. 52 with a pair of rotatable pulleys, andarticulation cables thereon;

FIG. 54 is a top perspective view of the proximal end of the cartridgecarrier portion shown in FIG. 53 with the intermediate pivot and asecond pair of rotatable pulleys attached thereto;

FIG. 55 is a top perspective view of the proximal end of the cartridgecarrier portion shown in FIG. 54 with the mounting member secured to theintermediate pivot;

FIG. 56 is an enlarged side perspective view of the distal end of thehandle portion and the proximal end of the central body portion of thesurgical stapling device with a half-section of the rotation controlmember removed;

FIG. 57 is a side perspective view from the top of a snap-fit button ofthe surgical stapling device shown in FIG. 56;

FIG. 58 is a second side perspective view from the top of the snap-fitbutton shown in FIG. 57;

FIG. 59 is a side cutaway view of the handle portion and central bodyportion of the surgical stapling device shown in FIG. 8 prior toarticulation of the surgical stapling device;

FIG. 60 is a side cross-sectional view of the carrier portion,intermediate pivot assembly and mounting member of the surgical staplingdevice shown in FIG. 59;

FIG. 61 is a top cross-sectional view of the carrier portion,intermediate pivot and mounting member shown in FIG. 60;

FIG. 62 is a side cutaway view of the handle portion and central bodyportion of the surgical stapling device shown in FIG. 59 with thearticulation actuator moved proximally;

FIG. 63 is a side cross-sectional view of the carrier portion,intermediate pivot and mounting member of the surgical stapling deviceshown in FIG. 62;

FIG. 64 is a top cross-sectional view of the carrier portion,intermediate pivot and mounting member of the SULU of the surgicalstapling device shown in FIG. 62;

FIG. 65 is a side cutaway view of the carrier portion, intermediatepivot and mounting member of the surgical stapling device shown in FIG.8 showing the articulation cables partly in phantom and with the SULU ina non-articulated position;

FIG. 66 is a side view of the handle portion of the surgical staplingdevice shown in FIG. 8 with the articulation actuator moved to a firstposition to articulate the tool assembly of the SULU to a firstorientation;

FIG. 67 is a side view of the carrier portion, intermediate pivot andmounting member shown in FIG. 65 after the articulation actuator hasbeen moved to the position shown in FIG. 66;

FIG. 68 is a side view of the handle portion of the surgical staplingdevice shown in FIG. 8 with the articulation actuator moved to a secondposition to articulate the tool assembly of the SULU to a secondorientation;

FIG. 69 is a side view of the carrier portion, intermediate pivot, andmounting member as shown in FIG. 65 after the articulation actuator hasbeen moved to the position shown in FIG. 68;

FIG. 70 is a bottom view of the carrier portion, intermediate pivot andmounting member shown in FIG. 65;

FIG. 71 is a top view of the handle portion of the surgical staplingdevice shown in FIG. 8 with the articulation actuator moved to a thirdposition to articulate the tool assembly to a third orientation; and

FIG. 72 is a bottom view of the carrier portion, intermediate pivot andmounting member as shown in FIG. 70 after the articulation actuator hasbeen moved to the position shown in FIG. 71.

FIG. 73 is a top view of the handle portion of the surgical staplingdevice shown in FIG. 8 with the articulation actuator moved to a fourthposition to articulate the tool assembly to a fourth orientation; and

FIG. 74 is a bottom view of the carrier portion, intermediate pivot andmounting member as shown in FIG. 70 after the articulation actuator hasbeen moved to the position shown in FIG. 73.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Preferred embodiments of the presently disclosed stapling device willnow be described in detail with reference to the drawings in which likereference numerals designate identical or corresponding element in eachof the several views.

U.S. provisional application Ser. No. 60/416,088 filed Oct. 4, 2002 andU.S. provisional application Ser. No. 60/416,372 filed Oct. 4, 2002 areincorporated herein by reference in their entirety.

Throughout this description, the term “proximal” will refer to theportion of the device closest to the operator and the term “distal” willrefer to the portion of the device furthest from the operator.

FIGS. 1-8 illustrate one embodiment of the presently disclosed surgicalstapling device shown generally as 10. Briefly, surgical stapling device10 includes a proximal handle portion 12, an elongated central bodyportion 14 and a distal disposable loading unit (“DLU”) 16. Preferably,the DLU is a single use loading unit (“SULU”). Handle portion 12includes a body 13 defining a stationary handle 18, a trigger 20, arotation control member 22 for rotating and an articulation actuator 24.Body 13 includes a pair of molded half-sections 13 a and 13 b, which maybe formed of a thermoplastic material, e.g., polycarbonate. Alternately,other materials having the requisite strength requirements may be usedto form body 13, e.g., surgical grade metals. Body 13 half-sections 13 aand 13 b are secured to each other using known fastening techniques,e.g., adhesives, welding, interlocking structure, screws, etc.Alternately, other fastening techniques may be used.

Referring to FIGS. 9-16, handle portion 12 includes anapproximation/firing mechanism for approximating the jaws of SULU 16 andejecting staples from SULU 16 as will be described in detail hereinbelow. The approximation/firing mechanism includes a spindle 26 whichdefines diametrically opposed guide tracks 28 and 30 (FIG. 16). Theproximal end of spindle 26 includes an extension 32 defining an annularrecess 32 a (FIG. 11). Extension 32 is received within a recess 34defined in body half-sections 13 a and 13 b of handle portion 12 torotatably fasten spindle 26 within body 13. A pinion 36 (FIG. 16) isrotatably secured in a throughbore 38 formed in a central portion ofspindle 26. Pinion 36 includes gear teeth which extend into guide tracks28 and 30.

Referring to FIG. 16, a firing rack 40 is slidably received in guidetrack 28 of spindle 26 and a retraction rack 42 is slidably received inguide track 30 of spindle 26. Firing rack 40 includes gear teeth 44 and46 formed on opposite sides of the rack. Gear teeth 44 are positioned toengage the teeth of an advancement and firing pawl 48 (“firing pawl”).Gear teeth 46 are positioned to engage the teeth of pinion 36. Theproximal end of firing rack 40 includes a cutout 50 which is dimensionedto engage a grasper pawl 52 in a manner to be discussed in detail below.

Retraction rack 42 also includes gear teeth 54 and 56 formed on oppositesides of the rack. Gear teeth 54 are positioned to engage the teeth of aretraction pawl 58 and gear teeth 56 are positioned to engage the teethof pinion 36. The proximal end of retraction rack 42 includes a bore 42a for receiving a pin 60 a of an indicator ring 60. Indicator ring 60 ispositioned about spindle 26 and is secured to and movable withretraction rack 42. Preferably, indicator ring 60 is colored tofacilitate viewing, e.g., red. A window or transparent portion (notshown) of body 13 of handle portion 12 permits viewing of the positionof indicator ring 60. Indicia may be provided on body 13 adjacent theviewing portion to identify the stage of operation of the device inrelation to the position of indicator ring 60.

Referring also to FIGS. 15 and 33, a barrel assembly 62 is slidablypositioned about spindle 26. Barrel assembly 62 includes firing pawl 48,grasper pawl 52, retraction pawl 58, a body portion 64, first and secondshift ring assemblies 66 and 68, and a trigger connector 70. Barrelassembly body portion 64 includes a pair of opposed throughbores 72 and74. Firing pawl 48 is pivotally secured within throughbore 72 about apivot pin 76 which extends through barrel assembly body portion 64.Retraction pawl 58 is pivotally secured within throughbore 74 about apivot pin 78 which extends through barrel assembly body portion 64. Aspring member or O-ring 80 is positioned about body portion 64 andengages firing pawl 48 and retraction pawl 58 to urge firing pawl 48 andretraction pawl 58 into engagement with firing rack 40 and retractionrack 42, respectively. Alternately, other biasing devices may be used tobias the firing pawl and retraction pawl into engagement with the firingand retraction racks. Firing pawl 48 includes a cam slot 48 a and seriesof teeth 48 b configured to engage teeth 44 of firing rack 40.Retraction pawl 58 includes a cam slot 58 a and a series of teeth 58 bconfigured to engage teeth 54 of retraction rack 42.

First shift ring assembly 66 includes an outer ring 82 and an inner ring84. Outer ring 82 is slidably positioned about barrel assembly bodyportion 64. Outer ring 82 includes a pair of cantilevered spring arms85. Each spring arm includes an outer abutment member 86 and an innerprotrusion 88. Inner ring 84 is slidably positioned about barrelassembly body portion 64 within outer ring 82 and includes an outerannular recess 90 dimensioned to receive protrusion 88 of spring arm 85in a manner to be described in detail below. Frictional contact betweenthe inner surface of inner ring 84 and the outer surface of barrelassembly body portion 64 retains the inner ring 84 at a fixed positionon the barrel assembly body portion 64 until inner ring 84 is manuallymoved.

Outer ring 82 is slidably positioned within handle body 13 and includesa pair of elongated ribs 92 on each side thereof. Ribs 92 define anelongated slot 94 which is dimensioned to slidably receive an elongatedrib 96 (FIG. 34) formed on an inner surface of body half-sections 13 aand 13 b (FIG. 35). The positioning of rib 96 in slot 94 restricts outerring 82 to linear movement. A pair of diametrically opposed prongs 98extend outwardly from each side of outer ring 82 through elongated slots100 (FIG. 34) formed in each of body half-sections 13 a and 13 b. Prongs100 are positioned on the handle body 13 at a position to be manipulatedby an operator of device 10 to move outer ring 82 linearly within handlebody 13 from an advanced to a retracted position.

Referring also to FIGS. 34-36, a cam surface 102 is formed on an innersurface of each of body half-sections 13 a and 13 b. Abutment member 86of spring arm 85 of outer ring 82 is positioned to slide over camsurface 102 as the outer ring 82 is moved from an advanced positionabout body portion 64 to a retracted position about body portion 64. Camsurface 102 includes a raised surface 102 a and recesses 102 b and 102 cpositioned at each end of cam surface 102. When outer ring 82 is movedlinearly within handle body 13 between the advanced and retractedpositions, abutment member 86 engages raised surface 102 a of camsurface 102 to push spring arm 85 inwardly such that inner protrusion 88moves into annular recess 90 of inner ring 84 about body portion 64.When inner protrusion 88 is received within annular recess 90 of innerring 84, linear movement of outer ring 82 is translated into linearmovement of inner ring 84. When abutment member 86 passes raised surface102 a, spring arm 85 moves outwardly such that abutment member 86 movesinto the recess 102 b or 102 c and inner protrusion 88 moves out ofannular recess 90 to disengage the inner and outer rings 82 and 84respectively.

A pin or rod 104 (FIG. 16) extends across inner ring 84 through firingpawl cam slot 48 a. A second pin or rod 106 extends across inner ring 84through retraction pawl cam slot 58 a. When inner ring 84 is moved fromthe advanced to the retracted position, pins 104 and 106 move withinfiring pawl cam slot 48 a and retraction pawl cam slot 58 a,respectively, to allow spring member 80 to move retraction pawl 58 intoengagement with the respective retraction rack 42 and to move firingpawl 48 out of engagement with firing rack 40. (See FIG. 33 g).

When inner ring 84 is moved from the retracted position to the advancedposition, pins 104 and 106 move within cam slots 48 a and 58 a,respectively, to pivot firing pawl 48 into engagement with firing rack40 and to allow spring member 80 to pivot retraction pawl 58 out ofengagement with retraction rack 42. (See FIG. 33).

Referring again to FIGS. 15, 16 and 33, second shift ring assembly 68(FIG. 16) also includes an outer ring 108 and an inner ring 110 andfunctions identically to the first shift ring assembly. Morespecifically, outer ring 108 is slidably positioned about barrelassembly body portion 64 and includes a pair of cantilevered spring arms112. Each spring arm includes an outer abutment member 114 and an innerprotrusion 116. Inner ring 110 is slidably positioned about barrelassembly body portion 64 within outer ring 108 and includes an annularrecess 118 dimensioned to receive protrusion 116 of spring arm 112 in amanner to be described in detail below. Frictional contact between theinner surface of inner ring 110 and the outer surface of the barrelassembly body portion 64 retains the inner ring 110 at a fixed positionon the barrel assembly body portion 64.

Outer ring 108 is slidably positioned within handle body 13 and includesa pair of elongated ribs 120 on each side thereof. Ribs 120 define anelongated slot 122 which is dimensioned to slidably receive an elongatedrib 124 (FIG. 34) formed on an inner surface of body half-sections 13 aand 13 b (FIG. 35). The positioning of rib 124 in slot 122 restrictsouter ring 108 to linear movement. A pair of diametrically opposedprongs 126 extend outwardly from each side of outer ring 108 throughelongated slots 128 (FIG. 36) formed in each of body half-sections 13 aand 13 b. Prongs 128 are positioned on the handle body 13 at a positionto be manipulated by an operator of device 10 to move outer ring 108linearly within handle body 13 from an advanced to a retracted position.

Referring also to FIGS. 34-36, a cam surface 130 is formed on an innersurface of each of body half-sections 13 a and 13 b. Abutment member 114of spring arm 112 of outer ring 108 is positioned to slide over camsurface 130 as the outer ring 82 is moved from its retracted position toits advanced position. Cam surface 130 includes a raised surface 130 aand recesses 130 b and 130 c positioned at each end of cam surface 130.When outer ring 108 is moved linearly within handle body 13 between itsadvanced position and its retracted position, abutment member 114engages raised surface 130 a of cam surface 130 to push spring arm 112inwardly such that inner protrusion 116 moves into annular recess 118 ofinner ring 110. When inner protrusion 116 is received within annularrecess 118 of inner ring 110, linear movement of outer ring 108 istranslated into linear movement of inner ring 110. When abutment member114 passes over raised surface 130 a, spring arm 112 moves outwardlysuch that abutment member 114 moves into the recess 130 b or 130 c andinner protrusion 116 moves out of annular recess 118 to disengage theinner and outer rings.

A pin or rod 132 (FIG. 16) extends across inner ring 110 through grasperpawl cam slot 52 a. When inner ring 110 is moved from its advancedposition to its retracted position on barrel assembly body portion 64,pin 132 moves within grasper pawl cam slot 52 a to pivot grasper pawl 52away from firing rack 40. When inner ring 110 is moved from itsretracted position to its advanced position, pin 132 moves withingrasper pawl cam slot 52 a to a position which allows a biasing member134 to urge a projection 52 b of grasper pawl 52 into firing rack cutout50. When projection 52 b of grasper pawl 52 is positioned in firing rackcutout 50, only limited advancement and retraction of the firing rack 40will occur upon operation of trigger 20, allowing the device to functionas graspers.

Referring again to FIGS. 9-16, barrel assembly 62 also includes atrigger connector 70 (FIG. 16) which includes an annular member 136rotatably secured about a distal end of barrel assembly body portion 64by a cap 138. In one embodiment, cap 138 is secured to the distal end ofbarrel assembly body portion 64 by a pair of pins 139 a and 139 b toretain annular member 136 on the distal end of barrel assembly bodyportion 64 between cap 138 and a shoulder 140 (FIG. 16) of barrelassembly body portion 64. Alternately, other fastening techniques may beused to secure cap 138 to barrel assembly body portion 64, e.g., screwthreads, adhesives, welding, etc. Annular member 136 includes a pair ofprongs 142 positioned to engage the trigger 20 in a manner to bedescribed below.

Trigger 20 includes a grip portion 144, an engagement portion 146, and apivot portion 148. Pivot portion 148 is formed at a top end of trigger20 and is configured to be pivotally secured between body half-sections13 a and 13 b about a pivot member 150 (FIG. 14). Engagement portion 146of trigger 20 includes a cylindrical member 152 for receiving barrelbody portion and a pair of U-shaped hook members 154. Hook members 154are dimensioned to slidably receive prongs 142 of annular member 136such that pivotal movement of trigger 20 effects linear movement ofbarrel assembly 62 about spindle 26. A biasing member 156 is positionedbetween trigger 20 and stationary handle 18 to urge trigger 20 to anon-compressed configuration. In one embodiment, biasing member 156includes a first part 156 a secured to trigger 20, such as by pins, anda second part 156 b secured to stationary handle 18 between bodyhalf-sections 13 a and 13 b via a hook 156 c positioned within a groove158 formed in stationary handle 18. First and second parts 156 a and 156b of two part biasing member 156 may be formed of spring steel and areslidably attached using a T-slot connector 160. Alternately, other knownbiasing devices or fastening techniques may be used.

In use, when trigger 20 is manually pivoted towards stationary handle 18in the direction indicated by arrow “A” in FIG. 33 e, barrel assembly 62is moved proximally over spindle 26 in the direction indicated by arrow“B”. If first shift ring assembly 66 is in its advanced position (FIG.33), i.e., positioned such that firing pawl 48 is engaged with firingrack 40, firing rack 40 is pushed proximally along guide track 28. Asthis occurs, pinion 36, which is engaged with firing rack 40 andretraction rack 42 will rotate and advance retraction rack along guidetrack 30. If first shift ring assembly 66 is in its retracted position(FIG. 33 g), i.e., positioned such that retraction pawl 58 is engagedwith retraction rack 42, retraction rack 42 will be pushed proximallyalong guide track 30 as barrel assembly 62 is moved by trigger 20proximally over spindle 26. As this occurs, pinion 36 is driven bymovement of retraction rack 42 to advance firing rack 40 distally.Operation of the grasper pawl 52 will be discussed in further detailhereinbelow.

Referring to FIGS. 9, 12 and 13, rotation control member 22 includeshalf-sections 22 a and 22 b which may be formed from a thermoplasticmaterial, e.g., polycarbonate. The proximal end of control member 22defines an inner annular channel 162 dimensioned to receive an annularrib 164 formed on the distal end of handle portion 12. Engagementbetween channel 162 and rib 164 rotatably fastens rotation controlmember 22 to handle portion 12. An actuator base member 166 has asemi-spherical outer surface 168 portion which is secured about rotationcontrol member 22. Actuator base member 166 is can be formed from moldedhalf-sections 166 a and 166 b which are fastened together about acentral portion of rotation control member 22 using any known fasteningtechnique, e.g., adhesives, welds, screws, etc. Articulation actuator 24which may also be formed from molded half-sections 24 a and 24 bincludes a semi-spherical inner surface 170 which is supported aboutsemi-spherical outer surface 168 of actuator base member 166 to permitgenerally omni-directional movement of articulation actuator 24 inrelation to base member 166, i.e., articulation actuator 24 can bepivoted in all directions about semi-spherical outer surface of basemember 166. Articulation actuator 24 is movable in relation to actuatorbase member 166 to effect articulation of the tool member of SULU 16 aswill be discussed in detail below.

Referring to FIGS. 9, 17 and 18, elongated body portion 14 includes anouter tube 172, an inner shaft 174, a plurality of articulation links176 a-d, a retraction link 178 and an advancement and firing link(“firing link”) 180. The proximal end 174 a of inner shaft 174 is flaredoutwardly and received within an annular channel 182 formed in handlebody 13 to rotatably secure inner shaft 174 to handle body 13. Innershaft 174 includes a central hub member 184 having a series ofcircumferentially spaced radially directed spokes 186. An alignment rod187 is secured within hub member 184 to assist in aligning elongatedbody portion 14 with a SULU 16. A semi-circular guide surface 188 issecured to or formed monolithically with a distal end of each spoke 186such that adjacent spokes 186 and respective guide surfaces 188 define aguide channel 190 for receiving each respective one of articulationlinks 176 a-d, retraction link 178 and firing link 180.

Referring to FIGS. 17 and 18, the distal end of each of articulationlinks 176 a-d, retraction link 178 and firing link 180 includesengagement structure including a pair of spaced fingers 192 a and 192 bwhich define a curved slot 192. Slot 192 is configured and dimensionedto receive the proximal end of respective articulation, retraction andfiring links of SULU 16 in a manner to be discussed in further detailbelow. A hole or bore 194 is formed through each of fingers 192 a and192 b. A leaf spring 196 is secured to the distal end of each of links176 a-d, 178 and 180 and includes a connector or linkage pin 198 securedthereto. Leaf spring 196, in its undeformed configuration, extendsoutwardly from a top surface of each link. Linkage pin 198 is supportedon leaf spring 196 such that when leaf spring 196 is deformed downwardlytowards the top surface of each link, linkage pin 198 is insertedthrough bore 194 in each of fingers 192 a and 192 b. Bore 194 isslightly elongated or oversized to accommodate the pivoted motion ofentry of linkage pin 198.

Referring to FIG. 40 a, the proximal end of retraction link 178 isfixedly secured to the distal end of retraction rack 42 and the proximalend of firing link 180 is fixedly secured to the distal end of firingrack 40. An intermediate link 200 may be used to connect the retractionand firing links to the retraction and firing racks. It is envisioned,however, that the retraction and firing links can be directly connectedto the retraction and firing racks, respectively. When an intermediatelink 200 is used, this link can be a rigid link which is pinned to arack and link such as shown in FIG. 40 a or a non-rigid link or cablewhich can be fastened between the links and racks using any knownfastening techniques, e.g., adhesives, knots, clamps, etc.

The term “rigid” in reference, e.g., to an articulation link, hereingenerally means that the overall link is sufficiently rigid or strong tobe operable for the purposes intended (here to effectively articulatethe tool assembly by use of the articulation actuator). Accordingly, forexample, the end portions of the link should be rigid enough toeffectively operably attach the end of the articulation link at theproximal end of the disposable loading unit to an adjacent distal end ofanother articulation link at the distal end of the central body portionof the surgical device. Likewise, and also to effectively and operablyattach the opposite end of the articulation link to a cable. In thiscontext here, attach means by any suitable structure or manner, e.g., sothat the forces imparted at the area of attachment do not sever thecable or tear the material of the link.

As shown in FIG. 17, the proximal end of each of articulation links 176a-d is connected to articulation actuator 24 by a non-rigid link 202,e.g., cable, rope, cord, wire, Kevlar strand, or any combinationthereof, etc. Alternately, rigid links may also be used to connect theproximal end of articulation links 176 a-d to articulation actuator 24.

Referring to FIGS. 9-14 and 17, links 202 are secured to the proximalend of articulation links 176 a-d and extend proximally through innershaft 174. In this embodiment, links 202 are connected to articulationlinks 176 a-d by passing link 202 through a hole near the proximal endof the links. Alternately, other attachment techniques may be used. Aplastic sleeve 175 (FIG. 9) may be secured within inner shaft 174 toprevent fraying of links 202. A plurality of radially orcircumferentially spaced apart openings 204 are formed through theproximal portion of inner shaft 174. Links 202 extend from within innershaft 174, through openings 204 in inner shaft 174, through elongatedslots 206 formed in outer tube 172 and through holes 208 formed inrotation control member 22 to a position adjacent articulation actuator24. The proximal end of each of links 202 is secured to articulationactuator 24 at locations evenly spaced about the circumference ofarticulation actuator 24 (FIG. 10). Links 202 may be secured toarticulation actuator 24 using any known fastening techniques includingtying, adhesives, pins, etc. Thus, when articulation actuator 24 ismanipulated by an operator, e.g., pivoted or swiveled, this motion istranslated via links 202 into linear movement of articulation links 176a-d within guide channels 190 of inner shaft 174.

Referring again to FIGS. 17 and 18, each of articulation links 176 a-d,retraction link 178 and firing link 180 includes at least one concavity212 formed on a top surface thereof. Concavities 212 are configured anddimensioned to receive a locking member 214. A single locking member 214may be positioned to be received in concavities 212 formed in a pair ofadjacent links. Although locking member 214 is illustrated as a ballshaped member, it is envisioned that locking member 214 may assume otherconfigurations which are capable of performing the function discussedbelow. Each locking member is seated within cooperative concavities 212of adjacent links 176-180, such that when locking member 214 ispositioned within adjacent concavities 212, the adjacent links areprevented from moving axially in relation to each other and in relationto inner shaft 174.

Referring also to FIG. 9, outer tube 172 is slidably positioned aboutinner shaft 174. A hole 216 is formed in each guide surface 188 of innershaft 174 adjacent each concavity 212. Hole 216 is aligned withconcavities 212 in links 176 a-180, such that locking member 214 extendspartially through hole 216. Outer tube 172 also includes annularlyarranged ball release holes 218 a and a proximal series of annularlyarranged ball release holes 218 b. The proximal series of ball releaseholes 218 b are slidable into alignment with locking members 214. Distalseries of ball release holes 218 a are movable into alignment withlocking members positioned in SULU 16 as will be discussed in detailbelow. When outer tube 172 is in its retracted position about innershaft 174, the inner wall of outer tube 172 engages locking members 214and presses locking members 214 through holes 216 in inner shaft 174into concavities 212 of links 176-180 to lock links 176-180 axially inrelation to inner shaft 174 and each other. When the outer tube is movedto its advanced position about inner shaft, ball release holes 218 balign with locking members 214 to permit locking members 214 to movefrom concavities 212. Thus, when the device is actuated to fire orarticulate, movement of a link or links 176-180 urges locking members214 out of concavities 212 partially into ball release holes 218 b topermit movement of links 176-180 in relation to inner shaft 174.

Outer tube 172 also functions to deform leaf spring 196 on each of links176 a-180 when outer tube 172 is moved from its retracted position toits advanced position. This occurs when the distal end of outer tube 172advances over leaf springs 196 to force leaf springs 196 towards the topsurface of each of links 176 a-180 (See FIG. 45). When leaf springs 196are pressed inwardly by outer tube 172, linkage pins 198 are movedthrough holes 194 in fingers 192 a and 192 b to secure a SULU 16 to thedistal end of elongated body portion 14 as will be discussed in furtherdetail below.

Referring to FIGS. 9 and 56-58, a pair of snap-fit buttons 220 arepositioned to extend through slots 222 (FIG. 9) formed in rotationcontrol member 22. Snap-fit buttons 220 each include an L-shaped body220 a having a projection 220 b formed at one end of the body and afinger engagement member 220 c on the other end of the body 220 a. Eachengagement member 220 c is accessible by an operator from a locationadjacent rotation control member 22 (FIG. 1). Each L-shaped body 220 aextends through a respective slot 222 in rotation control member 22adjacent the other L-shaped body 220 a over a top surface of outer tube172 such that projection 220 b engages a sidewall of outer tube 172opposite engagement member 220 c. Snap-fit buttons 220 are formed of aresilient material, e.g., plastic, spring steel, etc. Outer tube 172includes a pair of diametrically opposed cutouts 224. When outer tube172 is moved from its retracted to its advanced position, projections222 b of snap-fit buttons 222 snap into cutouts 224 to lock outer tube172 in its advanced position. Snap-fit buttons 222 can be pressedtogether by pressing on engagement members 222 c to flex projections 222b outwardly and remove projections 222 b from cutouts 224 to releaseouter tube from its advanced position.

Referring to FIGS. 5-8 and 18 a-24, SULU 16 includes a proximal bodyportion 230, a distal tool assembly 232 and an intermediate pivot member233. Distal tool assembly 232 includes an anvil assembly 234 and acartridge assembly 236. Anvil assembly 234 includes an anvil bodyportion 238 and an anvil plate portion 240 (FIG. 19) Anvil plate portion240 includes along its underside a plurality of staple deforming pockets(not shown) as known in the art. Anvil plate portion 240 is secured toanvil body portion 238 using any known fastening technique, e.g.,welding, crimping, etc. In an assembled condition, anvil body portion238 and anvil plate portion 240 define a gap or cavity 241 therebetween(FIG. 19). The proximal end of anvil body portion 238 includes a pair ofhinge members 242 a and 242 b. The proximal portion of anvil plateportion 240 defines a cam surface 244. An elongated slot 246 extendsfrom the proximal end of anvil plate portion 240 towards the distal endof anvil plate portion 240.

Cartridge assembly 236 includes a carrier portion 250 which defines anelongated support channel 252 dimensioned to receive a staple cartridge254. Corresponding slots and grooves in the cartridge 254 and carrierportion 250 function to retain cartridge 254 within support channel 252.Staple cartridge 254 includes a plurality of staple slots or pockets 256for receiving a plurality of fasteners, e.g., staples, and pushers (notshown) as is known in the art. A plurality of spaced apart internallongitudinal slots (not shown) extend through staple cartridge 254 toaccommodate upstanding cam wedges 258 of an actuation sled 260. Acentral longitudinal slot 262 extends along the length of staplecartridge 254 to facilitate linear movement of a knife bar 264 throughcartridge 254. Knife bar 264 includes a knife blade 266 and a transversecamming member 268 which is positioned to travel through cavity 241 ofanvil assembly 234. Knife bar 264 is positioned proximal to and incontact with actuation sled 260. A pair of holes 270 and 272 areprovided in knife bar 264. Hole 270 facilitates engagement or attachmentof a firing cable 274 (FIG. 24) to knife bar 264. Hole 272 facilitatesengagement or attachment of a retraction cable 276 (FIG. 24) to knifebar 264.

Carrier portion 250 has a pair of hinge members 278 a and 278 b formedon a proximal end thereof. The proximal surface of each hinge member 278a and 278 b can be semi-circular and cam include a series of serrationsor teeth 280. The function of teeth 280 will be discussed in furtherdetail below. A pivot pin 282 (FIG. 51) extends between hinge members242 a and 242 b and hinge members 278 a and 278 b such that anvilassembly 234 is pivotal in relation to cartridge assembly 236 betweenspaced and approximated positions relative to anvil body portion 238.

A guide cap 284 (FIG. 21) or other suitable structure can be provided orsecured to the distal end of carrier portion 250. Guide cap 284 or thestructure can define for example a pair of tracks 286 a and 286 b and acentral throughbore 288 for receiving and guiding cables of a cabledrive system for effecting approximation of the anvil and cartridgeassemblies and ejection of staples which will be discussed in furtherdetail below. Guide cap 284 may be secured to carrier portion 250 usingany known fastening technique, e.g., snap-fit tabs, screws, adhesives,welds, etc. A channel cover 290 can be secured to each side of carrierportion 250. Each channel cover 290 is secured to a side wall of carrierportion 250 using tabs 292 which are lockingly received in slots 294formed in carrier portion 250. Channel covers 290 define cable channels,for example, 291 a and 291 b, for firing cable 274 along sidewalls ofcarrier portion 250. A pair of cutouts 296 a and 296 b are formed incarrier portion 250 to facilitate passage of firing cable 274 cable fromchannels 291 a and 291 b into cartridge support channel 252.

FIG. 24, shows a suitable cable arrangement or pathway for use with thedevices and SULUs disclosed herein. More particularly, firing cable 274can include a central portion which can extend through hole 270 in knifebar 264. Both ends of cable 274 extend distally from knife bar 264through suitable channels in or associated with actuation sled 260 andalong a central portion of carrier portion 250 of cartridge assembly236. A first end of firing cable 274 exits carrier portion 250 fromthroughbore 288 of guide cap 284 and is redirected around track 286 a.The second end of firing cable 274 exits carrier portion 250 fromthroughbore 288 of guide cap 284 and is redirected around guide track286 b. The first and second ends of firing cable 274 extend proximallythrough cable channels 291 a and 291 b, respectively, and reenter aproximal portion of carrier portion 250 through cutouts 296 a and 296 b,respectively, and each passes along opposite sidewalls of carrierportion 250 proximally towards a SULU firing link 310 as will bedescribed in detail below. The arrangement of firing cable 274 is suchthat when the first and second ends of firing cable 274 are pulledproximally by actuating trigger 20 with firing pawl 48 engaged in firingrack 40, knife bar 264 is pulled distally to approximate the anvilassembly 234 and cartridge assembly 236 and to cause sled 260 tosubsequently eject staples from staple cartridge 254.

A retraction cable 276 includes a central portion which operablyengages, here, extends through hole 272 in knife bar 264. Respectivefirst and second portions of retraction cable 276 extend proximally fromknife bar 264 and towards SULU retraction link 308 as will be describein detail below (FIG. 24).

Referring to FIGS. 8 and 18 a-18 e, the SULU proximal body portion 230(FIG. 8) includes a first fixed outer tube 300, a second movable outertube 302, an inner shaft 304, a plurality of articulation links 306 a-d,a retraction link 308 and a firing link 310. Inner shaft 304 is similarin structure to inner shaft 174 and includes a central hub member 312(FIG. 18 b), a plurality of circumferentially spaced spokes 314 and anouter cylindrical guide surface 316. Adjacent spokes 314 and guidesurface 316 define guide channels 318. Each guide channel 318 isdimensioned to slidably receive one of the articulation, retraction andfiring links.

Each of the articulation links 306 a-d, retraction link 308 and firinglink 310 includes a first end having a finger 320 (FIGS. 39 and 40)having a bore 322. Each finger 320 is dimensioned to be slidablyreceived in slot 192 between fingers 192 a and 192 b of a respective oneof links 176-180 of elongated central body portion 14 such that bore 322is substantially aligned with bore 194 of the respective body portionlink. A second end of each of articulation links 306 a-d, is adapted tooperably engage one end of one of articulation cables 401 a and 401 bfor effecting articulation of the device as will be discussed in furtherdetail below. The proximal end of retraction link 308 and firing link310 is adapted to engage the proximal end of retraction cable 276 andfiring cable 274, respectively. In one embodiment, articulation cables401 a and 401 b, retraction cable 276 and firing cable 274 include aproximal eyelet 403 (FIG. 18 a) which is pinned to the distal end of arespective link. Alternately, other attachment techniques may be used.

Fixed outer tube 300 can be secured to a distal end portion of innershaft 304 by a pin 324. Pin 324 extends through outer tube 300 and innershaft 304 to axially fix outer tube 300 to inner shaft 304. Outer tube302 can be slidably positioned about a proximal end of inner shaft 304.Inner shaft 304 includes an elongated longitudinal slot 326 extendingtherethrough. A pin 328 attached to outer tube 302 can be slidablypositioned in slot 326, such that outer tube 326 is movable in relationto inner shaft 304 between advanced and retracted positions. A biasingmember or spring 330 is positioned in compression between pins 324 and328 to urge outer tube 302 to its retracted position (FIGS. 18 d and 18e). A spring mount 332 may be provided on one or both pins 324 and 328to facilitate attachment of spring 330 to the pins 324 and/or 328.

Referring to FIG. 18 a, articulation links 306 a-d, retraction link 308and firing link 310 each include at least one concavity 334 formed on atop surface thereof which receives a locking member 338. A singlelocking member 338 may be positioned to be received in the concavitiesof two adjacent links. Inner shaft 304 includes an opening 336positioned adjacent each concavity. Each locking member 338 extendspartially through opening 336 and is engageable with an inner surface ofmovable outer tube 302 when movable outer tube 302 is not in itsadvanced position. Although locking member 338 is illustrated as beingspherical or ball-shaped, it is envisioned that other locking memberconfigurations are suitable for use. Engagement between the innersurface of outer tube 302 and locking member 338 forces each lockingmember 338 inwardly partially through opening 336 in inner shaft 304into concavities 334 to axially fix articulation links 306 a-d,retraction link 308 and firing link 310 to inner shaft 304. As will bediscussed in further detail below, when a SULU 16 is attached toelongated body portion 14 of device 10, movable outer tube 302 is movedby engagement with a distal end of outer tube 172 of elongated body 14to its advanced position on inner shaft 304 (FIG. 18 e). In its advancedposition, movable outer tube 302 is positioned distally of lockingmembers 338 and locking members 338 are received within distal ballrelease openings 218 a formed in outer tube 172 of elongated bodyportion 14 (FIG. 18 e). When locking members 338 are positioned withinopenings 218 a, links 306-310 are axially movable in relation to innershaft 304.

Referring to FIGS. 18 a-18 e and 51, a mounting member, here shown ashollow mounting member 350, can define a throughbore 351, and can besecured within the distal end of inner shaft 304 by press fitting orusing other known attachment techniques, e.g., crimping, adhesives,pins, etc. Mounting member 350 includes a pair of diametrically opposedribs 352 which are received within slots 353 and 353 a formed in innershaft 304 and outer tube 300, respectively, to rotatably fix mountingmember 350 to the distal end of proximal body portion 230 of SULU 16.Mounting member 350 includes a pair of hinge members 354 a and 354 b.Each hinge member 354 a and 354 b includes a bore 356 for receiving apivot member 358, and a semi-circular set of teeth 360 which will bedescribed in further detail below.

As shown in FIG. 51, intermediate pivot member 233 includes a first setof hinge members 362 a and 362 b defining a first horizontal pivot axisand a second set of hinge members 364 a and 364 b defining a secondvertical pivot axis which is offset by about ninety degree from thefirst pivot axis. Hinge members 362 a and 362 b each include anelongated slot 363 for receiving pivot pin 282. Hinge members 364 a and364 b each include an elongated slot 365 for receiving pivot pin 358.Rotatable pulleys 366 and 368 are secured to hinge members 362 a and 362b. Rotatable pulleys 370 and 372 are secured to hinge members 364 a and364 b. Each of pulleys 366-372 defines a channel 374 for receiving oneof articulation cables 401 a and 401 b (FIG. 18 a). Pivot pin 282extends between hinge members 242 a and 242 b of anvil assembly 234,hinge members 278 a and 278 b of cartridge assembly 236 and hingemembers 362 a and 362 b of pivot member 233 such that anvil assembly 234is pivotable in relation to cartridge assembly 236 and tool assembly 232is pivotable in relation to intermediate pivot member 233 about thefirst horizontal axis. Because slots 363 in hinge members 362 a and 362b are elongated, the position of intermediate pivot member 233 ismovable in relation to tool assembly 232. Pivot pin 358 extends betweenpivot members 354 a and 354 b of hollow mounting member 350 and betweenpivot members 364 a and 364 b of intermediate pivot member 233, thelatter of which support tool assembly 232. As such, tool assembly 232 ispivotable in relation to elongated body portion 14 about the secondvertical axis “Z”. Because slot 365 in hinge members 364 a and 364 b iselongated, the position of intermediate pivot member 233 is movable inrelation to mounting member 350 of proximal body portion 230 of SULU 16.

Intermediate pivot member 233 includes a pair of first engagementmembers 380 positioned on top and bottom surfaces thereof. Firstengagement members 380 are positioned and configured to engage teeth 360of hinge members 354 a and 354 b when pivot pin 358 is pulled to itsforwardmost position within pivot slot 363. Engagement betweenengagement member 380 and teeth 360 locks the angular position ofintermediate pivot member 233 in relation to proximal body portion 230of SULU 16. A pair of second engagement members 382 are positioned onsidewalls of intermediate pivot member 233. Second engagement members382 are positioned and configured to engage teeth 280 formed on hingemembers 278 a and 278 b of carrier portion 250 when pivot pin 282 ispulled to proximalmost position within pivot slot 363. When secondengagement members 382 engage teeth 280, pivotal movement of toolassembly 232 along the y axis in relation to intermediate pivot member233 is prevented, i.e., the angular position of tool assembly 232 inrelation to intermediate pivot member 233 is locked.

Referring to FIGS. 51, 63 and 64, a flexible biasing member or spring ispositioned between pivot pins 282 and 358. The biasing member 390, whichmay be a compression spring, is in compression and is positioned to urgepivot pin 282 to its forwardmost position in slot 363 and urge pivot pin358 to its proximalmost position in slot 365. In these biased positions,engagement members 380 are disengaged from teeth 360 of SULU proximalportion 230 and engagement members 382 are disengaged from teeth 280 ofcartridge carrier portion 250 to facilitate articulation of the variouscomponents about the first horizontal axis and the second vertical axis.

Referring to FIGS. 62-64, first engagement members 380 and secondengagement members 382 can be brought in engagement with teeth 360 ofhinge members 354 a and 354 b and teeth 280 of hinge members 278 a and278 b, respectively, by pulling proximally on articulation actuator 24to increase the tension in articulation cables 401 a and 401 b (FIG.55). When tension in cables 401 a and 401 b overcomes the compressiveforce in spring 390, pivot pin 282 moves proximally in slot 363 to moveteeth 280 into contact with engagement member 382. Simultaneously, pivotpin 358 moves distally in slot 365 to move engagement member 380 intoengagement with teeth 360. As discussed above, when this occurs, thetool assembly 232 is locked at a fixed angular position with respect tointermediate pivot member 233 and intermediate pivot member 233 islocked at a fixed angular position with respect to proximal body portion230.

Referring to FIGS. 51-55, an articulation cable 401 a has a first end410 a attached to articulation link 306 a (FIG. 18 a). Articulationcable 401 a extends from articulation link 306 a along and through achannel 412 formed in mounting member 350, diagonally around pulley 370and through a channel 414 (FIG. 54) in intermediate pivot member 233.Articulation cable 401 a exits channel 414 and passes over one side ofpulley 368 and extends downwardly through a hole 416 in one side of abottom portion of the proximal end of carrier portion 250 and backupwardly through a hole 418 on the other side of the proximal end ofcarrier 250. Articulation cable 401 a then passes over one side ofpulley 366, extends through a second channel 420 formed throughintermediate pivot member 233, and passes around an opposite side ofpulley 370. The second end 410 b (FIG. 55) of articulation cable 401 aextends through and along a second channel 422 (FIG. 55) formed inmounting member 350 and is attached to articulation link 306 b.

Articulation cable 401 b has a first end 424 a attached to articulationlink 306 c. Articulation cable 401 b extends from articulation link 306c along and through a channel 426 (FIG. 55) formed in mounting member350, diagonally around one side of pulley 372 and through a channel 428(FIG. 50) formed in intermediate pivot member 233. Articulation cable401 b exits channel 428 and passes upwardly around one side of pulley368, and through an opening in a bracket 430 formed on one side of a topportion of the proximal end of cartridge carrier 250. Articulation cable401 b extends from bracket 430 through an opening in a second bracket432 on the other side of the proximal end of cartridge carrier 250downwardly around one side of pulley 366 and through a channel 434formed in intermediate pivot member 233. Articulation cable 401 b exitschannel 434, passes around the other side of pulley 372, and passesthrough and along a channel 436 formed in mounting member 350. Thesecond end 424 b of articulation cable 401 b exits channel 436 and isattached to articulation link 306 d.

In use, when ends 410 a and 410 b of articulation cable 401 a are pulledrearwardly together, tool assembly 232 is pivoted upwardly about thefirst horizontal pivot axis, i.e., about pivot pin 282. When ends 424 aand 424 b of articulation cable 401 b are pulled rearwardly together,tool assembly 232 is pivoted downwardly about pivot pin 282. When end410 a of articulation cable 401 a and end 424 a of articulation cable401 b are pulled rearwardly together, tool assembly 232 and intermediatepivot member 233 will pivot in a counter-clockwise direction as viewedin FIG. 55 about the second vertical axis, i.e., pivot pin 358. Theopposite will occur when ends 410 b and 424 b are pulled rearwardly. Anycombination of vertical and horizontal pivoting movements of toolassembly 232 can be achieved by pulling proximally on one or more of thearticulation cables.

Each of the articulation cables 401 a and 401 b are connected to thearticulation actuator 24 via articulation links 306 a-d of SULU 16,articulation links 176 a-d of central portion 14, and non-rigid links202. By manipulating articulation actuator 24, any combination ofmovements as described above can be performed such that tool assembly232 can be articulated in all directions, including those betweenhorizontal and vertical, to at least about ninety degrees. See forexample FIGS. 66-74.

Prior to using surgical stapling device 10, a SULU 16 is secured to thedistal end of elongated body portion 14. Referring to FIGS. 39, 40 and43-48, in order to connect SULU 16 to elongated body portion 14, fingers320 of SULU articulation links 306 a-d, retraction link 308 and firinglink 310 are positioned in slots 192 formed on the distal end ofelongated body articulation links 176 a-d, retraction link 178 andfiring link 180, respectively (FIG. 39). Next, elongated body outer tube172 is moved distally over inner shaft 174. As outer tube 172 movesdistally, the distal end of outer tube 172 engages leaf springs 196 topivot linkage pins 198 downwardly through bores 194 in fingers 192 a and192 b of the elongated body links 176 a-180 and through bore 322 offingers 320 of the SULU links 306 a-310. Outer tube 172 is advanceddistally into engagement with movable outer tube 302 of SULU proximalbody portion 230. As outer tube 172 is advanced further, movable outertube 302 is pushed distally over inner shaft 304 against the bias ofspring 330 until locking members 338 of proximal body portion 230 areuncovered by movable outer tube 302 and are received within distal ballrelease holes 218 a (FIG. 18 e) of outer tube 172. At this time, lockingmembers 214 of elongated body portion 14 are also received withinproximal ball release holes 218 b of outer tube 172, and snap-fitprotrusions 220 engage cutouts 224 in the proximal end of outer tube172. Engagement of snap-fit protrusions 220 in cutouts 224 locks outertube 172 in its advanced position (FIG. 56). The positioning of lockingmembers 338 in distal ball release holes 218 a and locking members 214in proximal ball release holes 218 b unlocks the SULU and central bodyarticulation, retraction and firing links in relation to inner shafts304 and 174 of DLU 16 and elongated body portion 14 to facilitatearticulation and firing of the stapling device.

As discussed briefly above, surgical stapling device 10 can be operatedas a grasper. Referring to FIG. 33, to utilize device 10 as a grasper,device 10 is maintained in or moved to the unclamped position and secondshift ring assembly 68 is moved to its advanced position by slidingouter ring 108 to its advanced position. As discussed above, when thisoccurs, inner ring 110 will advance to move cam pin 132 within cam slot52 b and allow spring 134 to move grasper protrusion 52 a into firingrack cutout 50. Advancement of outer ring 108 also affects advancementof outer ring 82 of first shift ring assembly 66 since outer rings 82and 108 are adjacent each other. When outer ring 82 is moved to itsadvanced position, firing pawl 48 engages firing rack 40. Thus, whentrigger 20 is actuated or compressed, barrel assembly 62 is movedproximally about spindle 26 to move firing rack 40 proximally. Whenfiring rack 40 moves proximally, firing link 180, SULU firing link 310and firing cable 274 are pulled proximally. When articulation cable 274is pulled proximally, knife bar 264 is moved distally such that cam bar268 engages cam surface 244 of anvil plate 240 and pivots anvil assemblyabout pivot pin 282 towards cartridge assembly 236 to provide a graspingfunction relative to tissue in the jaws of tool assembly 232. Sincegrasping pawl 52 is engaged in cutout 50 of firing rack 40, when trigger20 is released by an operator and returned to its non-compressedposition by spring 156, firing rack 40 will return to its advancedposition. When this occurs, pinion 36 will concurrently drive retractionrack to its retracted position to return drive member 264 to itsretracted position and move the anvil and cartridge assemblies or jaws234 and 236, respectively to their open configuration. This process canbe repeated to utilize stapling device 10 as a grasper.

When it is desired to eject staples from device 10, grasper pawl 52 isdisengaged from firing rack cutout 50 by moving outer ring 108 of shiftring assembly 68 to its retracted position, and moving outer ring 82 ofshift ring assembly 66 to the advanced position to engage firing pawl 48with firing rack 40. Thereafter, movable trigger 20 can be compressedtowards stationary handle 18 through an actuation stroke to move firingrack 40 proximally within guide channel 28. As discussed above, movementof firing rack 40 proximally moves firing link 180, firing link 310 andfiring cable 274 proximally to move drive member 264 distally withintool assembly 32. It is noted that each actuation stroke of movabletrigger 20 effects a predetermined linear movement of drive member 264,e.g., 15 mm. As such, surgical device 10 may be used to fire multiplesize SULU's, e.g., 15 mm, 30 mm, 45 mm, 60 mm, etc. The first actuationstroke of movable trigger effects approximation of the anvil andcartridge assemblies 234 and 236. Each actuation stroke thereafteradvances drive member 264 approximately 15 mm through tool assembly 32.Thus, to fire a stapler having a 45 mm SULU, movable trigger would haveto be moved through four actuating strokes or (N/15+1) actuatingstrokes, where N is the length of the SULU.

In order to retract drive member 264 within tool assembly 32 to move thecartridge and anvil assemblies to their spaced positions, first shiftring assembly is moved to the retracted position to move retraction pawl58 into engagement with retraction rack 42. Thereafter, movable handle20 is moved through a sufficient number of actuation strokes to returndrive member 264 through tool assembly 32.

It will be understood that various modifications may be made to theembodiments disclosed herein. For example, it is envisioned that thesurgical stapling device disclosed may be used in association withSULU's which are not surgical stapling devices, e.g., graspers, clipappliers, dissectors, electrosurgical sealing devices, etc. As such, theterm “firing link” may include any link for effecting actuation of atool assembly. Further, the SULU may also include tool assemblies otherthan staplers or those devices which eject a fastener, e.g., grasper,sealing devices (electrosurgical and non-electrosurgical), etc.Moreover, although the stapling device is disclosed as having aremovable SULU, the tool assembly and intermediate pivot member may benon-removably fastened to the central body portion of the surgicalstapling device. Therefore, the above description should not beconstrued as limiting, but merely as exemplifications of preferredembodiments. Those skilled in the art will envision other modificationswithin the scope and spirit of the claims appended hereto.

1. A surgical stapling device comprising: a handle portion; an elongatedbody portion extending distally from the handle portion; a pivot memberconnected to the body portion adjacent a distal end of the body portionso that the pivot member is pivotable about a pivot axis; a toolassembly connected to the pivot member, the tool assembly including ananvil and a cartridge assembly having a staple cartridge; at least onecable connected to the handle portion, extending through the pivotmember; and a knife bar having at least one hole for receiving the atleast one cable.
 2. The surgical stapling device according to claim 1,wherein the at least one cable includes a firing cable, and the toolassembly includes a guide cap at a distal end of the tool assembly forguiding the firing cable so that the knife bar is pulled distallythrough the tool assembly.
 3. The surgical stapling device according toclaim 1, further comprising an actuation sled, the knife bar beingpositioned proximal to the actuation sled.